Pemphigoid gestationis in a resource-limited setting

Pemphigoid gestationis in a resource-limited setting: Fadimatu Bakari, Gabriel Dogbanya, Tahir Turaki Muhammad, Hajara Umaru-Sule, Hajaratu Umar Sulayman, Solomon Avidime, Adebiyi Gbadebo Adesiyun



Archives of International Surgery 2018 8(3):147-151



Pemphigoid gestationis is a rare autoimmune vesicobullous dermatosis that is unique to pregnancy. It commonly occurs during the second half of pregnancy, particularly the 3rd trimester. In general, it presents with intense, itchy erythematous papules and plaques that often spares the palms and soles. These lesions culminate to form intense bullae that often become secondarily infected if neglected. Vertical transmission of maternal antibodies in utero can occur and the infants could present with similar lesions for few weeks postdelivery. In resource-rich setting, the diagnosis is often confirmed with the direct immuno-fluorescence study, but in a resource-limited setting, a high index of suspicion is required to make a clinical diagnosis and commence prompt therapy to optimize maternal and fetal outcomes. We report a case of a 32-year-old grand multipara who presented at 34 weeks gestation with a 12-week history of infected skin lesions characteristic of pemphigoid gestationis. She was commenced on steroid therapy and antibiotics based on the clinical diagnosis. She went into preterm spontaneous labor at 36 weeks and delivered a boy baby who manifested with similar lesions at 2 weeks of live.